Integra dermal matrix skin substitute at AMH Cath Labs LLC

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

MATRIX INTEGRA WND 5X5/25SQCM

Arlington, TX

See all hospitals reporting HCPCS Q4108 →

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Pricing by billing methodology

Price type

How this price compares nationally

AMH Cath Labs LLC’s median price of $138 is 5% above the median hospital's median price ($132), higher than 55% of the 1,390 hospitals reporting HCPCS Q4108. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4108 at AMH Cath Labs LLC

Negotiated rates from the hospital’s own file: 9 payers, 33 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges	$38	$38	$19	51%	—	$18 – $58
2	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$38	$38	$19	51%	—	$18 – $58
3	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$40	$40	$20	51%	—	$19 – $61
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$41	$41	$21	51%	—	$20 – $62
5	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$42	$42	$21	51%	—	$20 – $63
6	Blue Cross Blue Shield hmo fee schedule · outpatient	$80	$80	—	—	—	$80 – $80
7	Blue Cross Blue Shield exchange fee schedule · outpatient	$82	$82	—	—	—	$82 – $82
8	Blue Cross Blue Shield ppo fee schedule · outpatient	$89	$89	—	—	—	$89 – $89
9	Blue Cross Blue Shield medicare advantage case rate · outpatient	$125	$125	—	—	—	$125 – $125
10	Humana medicare advantage case rate · outpatient	$130	$130	—	—	—	$130 – $130
11	Humana medicare advantage ppo case rate · outpatient	$130	$130	—	—	—	$130 – $130
12	Molina medicare advantage case rate · outpatient	$131	$131	—	—	—	$131 – $131
13	WellCare medicare advantage hmo case rate · outpatient	$131	$131	—	—	—	$131 – $131
14	WellCare medicare advantage mmp case rate · outpatient	$138	$138	—	—	—	$138 – $138
15	UnitedHealthcare medicare advantage ppo case rate · outpatient	$139	$139	—	—	—	$139 – $139
16	UnitedHealthcare medicare advantage hmo case rate · outpatient	$142	$142	—	—	—	$142 – $142
17	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$147	$148	$75	51%	—	$71 – $224
18	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$175	$175	$89	51%	—	$85 – $266
19	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$196	$197	$99	51%	—	$95 – $299
20	UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges	$220	$221	$112	51%	—	$107 – $335
21	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$233	$234	$118	51%	—	$113 – $355
22	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$234	$234	$118	51%	—	$113 – $355
23	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$236	$236	$119	51%	—	$114 – $358
24	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$296	$297	$150	51%	—	$143 – $450
25	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$297	$297	$150	51%	—	$144 – $452

Page 1 of 2 · 33 rates

Last updated: Apr 21, 2026

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